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INSTRUCTIONS <br /> 1. A sanitary permit is valid for two (2) years- <br /> ._. Your sanitary permit may be renewed before the expiration date, ane at the time of renewal any new <br /> criteria in the Wisconsm Administrative Code wi!I be apphcabie. <br /> 3 Ail revisions to this permit must be approved by the permit issuing authority. <br /> 4. Changes in ownership plumber requires a Sanitary Permit Transter/Renewal Form (SB0 6399; to be <br /> submitted-to the county prior to installation. <br /> S Onsite sewage systems must he properly mamtaincd- The septic to"else mus' be pumped by a hcersed - <br /> pumper whenever necessary, usually ove;y 2 3 yaar:� - <br /> 6. If you have questions concerning your onsite sewage system, contact your local code administrator or fhe <br /> State of Wisconsin, Safety & Buildings Division, 609-266-3815. <br /> To be complete and accurate this sanitary permit application must include. <br /> I. Property owner's name and mading address. Prcvid= the legs! desc,r,t,en Ana parser tax numher(s? <br /> .vhere the system is to be installed. <br /> li Type of building being served. Check only one and complete # of Cod:toms i! 1 or 2 gamily uw�-fii g. <br /> Ili. Building use. If building type is Public, check all appropriate boxes that apply. <br /> iV Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or <br /> repair. <br /> V Type of system. Check appropriate box depending on system type. <br /> VI Absorption system information. Provide al! information requested in #1-?. <br /> VII Tank information. Fill in the capacity or every new arw;or existing tank. Irsi the total gallons, numberof <br /> tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complet for all <br /> septic, pump/siphon and holding tanks for this system. Check experimental approval only .f tanks received <br /> experimental product approval from DILHR. <br /> VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. <br /> MP, etc.), address and phone number. Plumber must sign application form. <br /> IX. County/Department Use Only. <br /> X. County/Department Use Only. <br /> Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The <br /> plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of <br /> holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells, water mains/water service; <br /> streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system <br /> areas, and the location of the building served; B) horizontal and vertical elevation reference points, <br /> C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump <br /> performance curve; pump model and pump manufacturer, D) cross section of the soil absorption system if <br /> required by the county; E) soil test data on a 115 form; and F) all sizing information. <br /> ---------------------------------------------------------------------------------------------------------------------------------------------- <br /> GROUNDWATER SURCHARGE <br /> 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of <br /> regulated practices which can effect groundwater. <br /> The monies collected through these surcharges are used for monitoring groun dwater, ground- <br /> water contamination investigations and establishment of standards. <br /> SBD-6398 (11.11/88) <br />